RESUMEN Objetivo: Describir las características de la implementación del tratamiento supervisado por video (VDOT) en pacientes con tuberculosis en un establecimiento de salud de la seguridad social del primer nivel de atención en Perú (EsSalud). Material y métodos: Estudio observacional, descriptivo. Los pacientes fueron enrolados de forma prospectiva de 18/09/2018 al 24/09/2019. Ocho de los nueve pacientes seguidos completaron el tratamiento VDOT. Un paciente fue transferido a otro establecimiento de salud antes de terminar el seguimiento. Una enfermera entrenada de Socios En Salud gestionó las 727 video llamadas. Resultados: Se obtuvo una adherencia al tratamiento del 100%. Conclusiones: La estrategia VDOT sería una modalidad alternativa útil en pacientes con tuberculosis sensible.

SUMMARY Objective: To report the characteristics of the implementation process of the video supervised treatment (VST) of patients with pulmonary tuberculosis in a first level health care center of the Social Security in Peru. Methods: An observational study was carried-out including patients enrolled from 18/09/2018 to 24/09/2019. Eight out of ninepatients completed the VST, one patient was transferred to other institution before finishing treatment. One nurse trained at Partners in Health arranged the 727 video calls. Results: adherence to treatment was 100%. Conclusions: VST may be a useful alternative for patients with drug sensitive tuberculosis.

Resumen Descripción del caso clínico: Paciente masculino de 55 años que consultó por presentar dolor lumbar izquierdo y disuria. Se diagnosticó por estudio sonográfico y tomografía contrastada del abdomen una duplicidad ureteral completa con inserción ureteral ectópica en la uretra prostática. Se realizó nefroureteroectomía mediante abordaje laparoscópico ante la pérdida de la función renal. Relevancia: La inserción ureteral ectópica es una anomalía congénita rara que se presenta con duplicidad ureteral completa con una incidencia de 0.05 a 0.025%. Su diagnóstico es aún más infrecuente en la adultez. Implicaciones clínicas: El estudio del paciente por imágenes permitió realizar el diagnóstico de esta infrecuente entidad en un paciente adulto. La nefrectomía mediante abordaje laparoscópico fue el tratamiento indicado con una evolución muy satisfactoria. Conclusión: La ectopia ureteral es una anomalía congénita rara. Su diagnóstico en la adultez es menos frecuente aún. La ultrasonografía y TAC contrastada del abdomen permitieron el diagnóstico. La nefrectomía laparoscópica fue el tratamiento indicado por la pérdida de la función renal.

Abstract Description of the clinical case: A 55-year-old male patient consulted due to left lumbar pain and dysuria. A complete ureteral duplication with ectopic ureteral insertion in the prostatic urethra was diagnosed by sonographic study and contrast tomography of the abdomen. Nephroureteroectomy was performed using a laparoscopic approach due to the loss of renal function. Relevance: Ectopic ureteral insertion is a rare congenital anomaly that presents with complete ureteral duplication with an incidence of 0.05 to 0.025%. Its diagnosis is even more infrequent in adulthood. Clinical implications: The study of the patient by imaging allowed the diagnosis of this rare entity in an adult patient. Laparoscopic nephrectomy was the indicated treatment with a very satisfactory evolution. Conclusion: Ureteral ectopy is a rare congenital anomaly. Its diagnosis in adulthood is even less frequent. Contrast ultrasound and CT of the abdomen allowed the diagnosis. Laparoscopic nephrectomy was the treatment indicated for the loss of renal function.

RESUMO Ananas comosus var. ananassoides (Baker) Coppens & F.Leal é uma bromélia ornamental nativa do Cerrado, um bioma ameaçado de extinção, sendo necessários estudos para sua preservação, como o uso de micropropagação. O nutriente nitrogênio (N) é absorvido pelas plantas, principalmente, como NO3- e/ou NH4+ e é assimilado em aminoácidos. O objetivo deste trabalho foi avaliar a assimilação de N nesta bromélia. As plantas foram cultivadas in vitro por sete meses em meio MS modificado com 15, 30, 60 e 90 mM de N como NO3-, NH4+ ou NH4NO3, depois as plantas foram aclimatizadas ex vitro. Plantas cultivadas com NH4+ tiveram alta mortalidade. Durante a aclimatização, plantas cultivadas com 30, 60 e 90 mM de N como NH4NO3 apresentaram maior biomassa. Em relação à assimilação do N, GS e NR apresentaram as maiores atividades em plantas cultivadas com NH4NO3, e as adubadas apenas com NH4+ tiveram alta atividade da GDH. Consequentemente, recomenda-se cultivar esta espécie in vitro e ex vitro com 60 mM de N como NH4NO3.

ABSTRACT Ananas comosus var. ananassoides (Baker) Coppens & F.Leal is a native ornamental bromeliad of the endangered biome Cerrado. Therefore, approaches aimed at the preservation of this species, such as in vitro cultivation and micropropagation are needed. Nitrogen (N) is absorbed by plants, mainly as NO3- and/or NH4+, and assimilated into amino acids. The aim of this work was to evaluate the N assimilation in this bromeliad. Plants were grown in vitro for seven months in modified MS medium with 15, 30, 60, and 90 mM of N as NO3-, NH4+ or NH4NO3, and then transferred to ex vitro conditions for acclimatization. Plants grown with NH4+ had high mortality. During acclimatization plants cultivated with 30, 60, and 90 mM of N as NH4NO3 showed higher biomass. With regard to N assimilation, GS and NR showed the highest activity in plants cultivated with NH4NO3, whereas plants cultivated with NH4+ had the highest GDH activity. Consequently, in vitro and ex vitro cultivation of this species with 60 mM N as NH4NO3 is recommended.